Delphine Kerob

Background: Acne vulgaris is a common skin condition that typically begins in adolescence but can often persist in adulthood, contributing to significant physical and psychosocial burden. Despite the availability of multiple treatment options, challenges such as poor adherence, treatment‐related side effects, and post‐inflammatory hyperpigmentation remain common in clinical practice. Dermocosmetics are increasingly used in acne management, either alone in mild cases or as adjuncts to medical therapy. Objectives: To assess acne prevalence, treatment practices, and key management challenges, along with the role of dermocosmetics, based on expert consensus from India. Methods: A panel of 10 dermatologists participated in a modified Delphi process comprising a pre‐meeting survey followed by a structured advisory board discussion, capturing clinical practice patterns, treatment approaches, and perspectives on dermocosmetic use in acne management. Results: Experts reported treating a high number of acne patients, primarily adolescents, with a higher proportion of females. Hyperpigmentation and scarring were common sequelae of acne, while treatment adherence and antibiotic resistance, particularly to erythromycin and azithromycin, were noted as key challenges. Procedural interventions, including chemical peels, lasers, and comedone extraction, were increasingly used in early acne management, especially in patients prone to post‐inflammatory hyperpigmentation and relapse. Low‐dose isotretinoin and hormonal therapies were commonly used in acne management, while dermocosmetics were utilized as monotherapy in mild cases and as maintenance therapy following treatment in more severe cases. Lifestyle factors such as high glycaemic diets, whey protein, multivitamins, and steroid‐like drugs were identified as potential contributors to acne exacerbation. Limitations: Findings are based on a small expert panel convened with industry support and reflect clinical opinion rather than primary patient data. Conclusion: Procedural interventions are becoming more popular, thereby providing an opportunity to incorporate dermocosmetics into acne treatment regimens.

Acne vulgaris pathogenesis involves complex interactions between sebum hypersecretion, follicular hyperkeratinisation, microbial colonisation and inflammatory cascades. While the bacterial microbiome has been extensively studied, the role of the skin mycobiome, particularly lipophilic Malassezia species, remains less clearly defined in acne‐prone sites. To evaluate evidence for skin mycobiome involvement in acne pathogenesis, a structured narrative review was conducted in PubMed/MEDLINE and PMC, synthesising findings from 14 cross‐sectional studies involving 1650 participants from diverse geographic and ancestry backgrounds. Across sequencing and culture‐based studies, Malassezia was the dominant fungal genus on healthy as well as acne‐prone skin; species‐level data most often identified M. restricta and M. globosa , with occasional reports of M. furfur . Although significant variations were observed in fungal abundance, discrepancies exist between studies due to differences in study design, sampling methods (surface swabs vs. comedone or pustule contents vs. pore strips), culture media (lipid‐supplemented vs. standard), molecular target (ITS1 rDNA vs. other loci) and population demographics. Multiple sequencing studies did not detect significant fungal alpha/beta‐diversity differences between acne and non‐acne skin while confirming Malassezia species dominance. One study highlighted the potential underdiagnosis of Malassezia folliculitis in acne patients, suggesting that misdiagnosis may occur due to overlapping clinical presentations. Future studies should predefine primary outcomes, adjust for multiplicity, report sampling depth (surface vs. follicular), specify fungal rDNA region sequenced, use specific lipid‐supplemented media for Malassezia isolation when culturing, co‐profile bacteria and fungi, and add systematic clinical assessment of Malassezia folliculitis.

Introduction and Objectives: Adult acne significantly impacts quality of life (QoL) and self‐esteem. Expert recommendations and guidelines recognize the role of dermocosmetics, either as a monotherapy for the mild to moderate forms, or as an adjunctive to acne medications in more severe forms. However, clinical data regarding the benefits of dermocosmetics in adult acne, with clinical visualization across all phototypes, is still lacking. This study assessed the benefit of an ultra‐concentrated tri‐acid complex serum (DC serum) in adult acne management in subjects of any skin phototype. Material and Methods: In an open‐label, multicentric study, 87 adult subjects of any phototype with a mean age of 25 ± 1 years, presenting mild to moderate acne (GEA 2–3), were recruited. DC serum was applied twice daily on the face for 168 days. Assessments comprised Global Evaluation of Acne (GEA) grading, submandibular acne scoring (in female participants only), and inflammatory lesion counts. Additionally, skin hydration levels, signs of cutaneous aging, quality of life (via the AI‐ADL scale), stigmatization (via PUSH‐D), local tolerance, and subject satisfaction rates were evaluated, alongside standardized clinical photography. Results: A significant ( p < 0.0001) decrease in all lesion counts was observed starting 14 days. At Day 168, the inflammatory lesion count had decreased by 55%, that of non‐inflammatory lesions by 61%, and that of total lesions by 59%. The GEA score had significantly ( p < 0.0001) decreased from Day 14, sustaining till Day 168 (−36%; 62% of subjects with an improvement). In women with submandibular acne, a 12%‐improvement at Day 14 ( n = 63, p = 0.0078) and a 43%‐improvement at Day 168 ( n = 56, p < 0.0001) were observed. Skin hydration had increased, and skin aging signs had significantly ( p < 0.0001) improved at D168. Conclusion: DC serum is beneficial in mild to moderate adult acne across all phototypes, providing a continuous improvement of acne, skin hydration, and a reduction of early skin aging signs overtime.

Background: Post‐inflammatory hyperpigmentation (PIH) is a condition that causes skin pigmentation after acute or chronic inflammation. It affects people with darker skin tones more than others, especially Asians (Fitzpatrick types III–VI), and can last for months or even years, making life much less enjoyable. Dermocosmetics' role in preventing and treating PIH is understudied, despite its prevalence and stressfulness. Aims: Systematic evaluation of the clinical efficacy and safety of topical medical skincare products for treating post‐inflammatory hyperpigmentation (PIH). Methods: Databases including PubMed, Embase, and the Cochrane Library were searched, enrolling five randomized controlled trials (RCTs) involving 444 PIH patients. Cochrane RoB 2 was used to assess risk of bias. A random‐effects model was applied to pool changes in Melanin Index (MI) and clinical scores, with evidence quality assessed using GRADE. Results: Compared with controls, skincare products significantly reduced MI (SMD −2.23, 95% CI −2.89 to −1.57) and improved clinical scores (SMD −2.10, 95% CI −2.76 to −1.44); no statistically significant difference in adverse reaction incidence (RR 1.05, 95% CI 0.82 to 1.34). Tyrosinase inhibitors showed the greatest effect, while antioxidants and sunscreen products demonstrated superior tolerability. Evidence grade: Low. Conclusion: Medical skincare products represent a safe and effective non‐invasive treatment option for PIH. However, due to limitations in sample size and heterogeneity, further validation through high‐quality, long‐term follow‐up RCTs is required. Trial Registration: PROSPERO number: CRD42023456789

Introduction and Objectives: Acne is a chronic inflammatory skin disease that can cause acne‐induced hyperpigmentation (AIH), especially in subjects with phototype IV and above (hereafter darker skin tones). This study evaluated the efficcay kinetics of a dermocosmetic cream (DC cream) in adults with darker skin phototypes and mild to moderate acne. Material and Methods: An intra‐individual, randomized, split face, single centre 57 day‐study was conducted in 16 adults with dark skin tones (phototype IV, V and VI) and mild‐to‐moderate acne. DC cream was applied 2/day on one hemiface. Assessments included total, inflammatory and non‐inflammatory lesion counts, AIH intensity and darkness severity, PAHPI score and local tolerance. Subjects rated the perceived benefits of DC cream. Results: 75% of subjects were women, mean age was 26.8 ± 6.7 years; 50% had phototype IV, 31.2% phototype V, and 18.8% phototype VI. 68.8% had mild (GEA 2) and 31.2% moderate (GEA 3) acne. The total lesion count significantly decreased from Day 5 (−17.1%; p < 0.05) until Day 57 (−44.9%; p < 0.01) on the DC‐treated side versus  − 28.4% on the untreated side at Day 57. Inflammatory and non‐inflammatory lesion counts significantly ( p < 0.01) decreased from Day 11 to Day 57 with DC cream. AIH marks intensity significantly ( p < 0.01) decreased starting Day 11 until Day 57; as did the PAHPI score (−22.7%) after 57 days with hemi‐face differences being significantly ( p < 0.05) in favor of DC cream. AIH darkness severity significantly improved with DC cream, with no changes on the untreated side. DC cream was highly appreciated and very well tolerated by the subjects. Conclusions: This clinical study provides strong evidence on the efficacy kinetics of a DC cream in acne management in subjects with dark skin tones. It shows that early, daily and specific treatment with a targeted DC significantly improves all acne lesions type, as well as AIH marks as soon as 11 days of use, in addition to exhibiting high patient satisfaction rates and excellent tolerability.

Background: Prescription acne products have proven efficacy and safety, yet management can pose a challenge. This review discusses the benefits of adding dermocosmetics to acne management. Methods: We add expert consensus with review of the literature to provide guidance for clinicians managing patients with acne in Latin America. Results: There is increasing evidence that dermocosmetics (over‐the‐counter cleansers, moisturizers, and sunscreens that contain acne‐targeting ingredients) can be a good alternative to prescription acne treatments as well as adjuncts. Milder forms of acne may be present in any age patient, but prepubertal acne and acne cosmetica may be particularly well suited to a dermocosmetic approach. More severe acne may need a dermocosmetic added if there is sensitive skin or poor tolerance to prescription medications, and when the patient or family does not wish to use antibiotics or other acne prescription treatments. Dermocosmetics may be used as adjuncts to any type of prescription therapy, but may be most effective when used with products associated with skin irritation such as topical retinoids or benzoyl peroxide. Appropriate dermocosmetics can also fortify the skin barrier and help to protect the skin microbiome. Conclusions: Acne management is complex and there can be adherence, tolerability, and efficacy problems. Dermocosmetics alone can be used in milder forms of acne or in maintenance post treatment, as a good compromise between efficacy and tolerability. As adjuncts, dermocosmetics can also decrease skin irritation and thereby increase adherence, can enhance the efficacy of prescription therapies, and can normalize dysbiosis in acne.

Prescription acne products have proven efficacy and safety, yet management can pose a challenge. This review discusses the benefits of adding dermocosmetics to acne management. We add expert consensus with review of the literature to provide guidance for clinicians managing patients with acne in Latin America. There is increasing evidence that dermocosmetics (over-the-counter cleansers, moisturizers, and sunscreens that contain acne-targeting ingredients) can be a good alternative to prescription acne treatments as well as adjuncts. Milder forms of acne may be present in any age patient, but prepubertal acne and acne cosmetica may be particularly well suited to a dermocosmetic approach. More severe acne may need a dermocosmetic added if there is sensitive skin or poor tolerance to prescription medications, and when the patient or family does not wish to use antibiotics or other acne prescription treatments. Dermocosmetics may be used as adjuncts to any type of prescription therapy, but may be most effective when used with products associated with skin irritation such as topical retinoids or benzoyl peroxide. Appropriate dermocosmetics can also fortify the skin barrier and help to protect the skin microbiome. Acne management is complex and there can be adherence, tolerability, and efficacy problems. Dermocosmetics alone can be used in milder forms of acne or in maintenance post treatment, as a good compromise between efficacy and tolerability. As adjuncts, dermocosmetics can also decrease skin irritation and thereby increase adherence, can enhance the efficacy of prescription therapies, and can normalize dysbiosis in acne.